Amendment SSA1-SB45

SB45-SSA1,1153,3 (g) "Nonprofit corporation" means a nonstock corporation organized under ch. 181 that is a nonprofit corporation, as defined in s. 181.0103 (17).

SB45-SSA1,1153,5 (h) "Poverty line" means the nonfarm federal poverty line for the continental United States, as defined by the federal department of labor under 42 USC 9902 (2).

SB45-SSA1,1153,6 (i) "State agency" has the meaning given in s. 16.70 (1).

SB45-SSA1,1153,7 (2) The department shall do all of the following:

SB45-SSA1,1153,10 (a) Identify the barriers to health care that prevent economically disadvantaged minority group members in this state from participating fully and equally in all aspects of life.

SB45-SSA1,1153,12 (b) Conduct statewide hearings on issues of concern to the health interests of economically disadvantaged minority group members.

SB45-SSA1,1153,15 (c) Review, monitor and advise all state agencies with respect to the impact on the health of economically disadvantaged minority group members of current and emerging state policies, procedures, practices, statutes and rules.

SB45-SSA1,1153,21 (d) Work closely with all state agencies, including the board of regents of the University of Wisconsin System and the technical college system board, with the University of Wisconsin Hospitals and Clinics Authority, with the private sector and with groups concerned with issues of the health of economically disadvantaged minority group members to develop long-term solutions to health problems of minority group members.

SB45-SSA1,1153,23 (e) Disseminate information on the status of the health of economically disadvantaged minority group members in this state.

SB45-SSA1,1154,3 (f) Encourage economically disadvantaged minority group members who are students to enter career health care professions, by developing materials that are culturally sensitive and appropriate and that promote health care professions as careers, for use by the University of Wisconsin System, the technical college system and the Medical College of Wisconsin in recruiting the students.

SB45-SSA1,1154,8 (g) Submit a biennial report on the activities of the department under this section that includes recommendations on program policies, procedures, practices and services affecting the health status of economically disadvantaged minority group members, to the appropriate standing committees under s. 13.172 (3) and to the governor.

SB45-SSA1,1154,15 (3) From the appropriation under s. 20.435 (5) (fh), the department shall award grants for activities to improve the health status of economically disadvantaged minority group members. A person may apply, in the manner specified by the department, for a grant of up to $50,000 in each fiscal year to conduct these activities. A grant awarded under this subsection may not exceed 50% of the cost of the activities. An applicant's required contribution for a grant may consist of funding or an in-kind contribution.

SB45-SSA1,1154,19 (4) From the appropriation under s. 20.435 (5) (fh), the department shall award a grant of up to $100,000 in each fiscal year to a private nonprofit corporation that applies, in the manner specified by the department, to conduct a public information campaign on minority health.

SB45-SSA1, s. 2241 Section 2241. 146.19 (2) (intro.) of the statutes is amended to read:

SB45-SSA1,1155,3 146.19 (2) Cooperative American Indian health project grants. (intro.) From the appropriation under s. 20.435 (5) (ek) (ke), the department shall award grants for cooperative American Indian health projects in order to promote cooperation among tribes, tribal agencies, inter-tribal organizations and other agencies and organizations in addressing specific problem areas in the field of American Indian health. A tribe, tribal agency or inter-tribal organization may apply, in the manner specified by the department, for a grant of up to $10,000 to conduct a cooperative American Indian health project, which meets all of the following requirements:

SB45-SSA1, s. 2241c Section 2241c. 146.19 (2m) of the statutes is created to read:

SB45-SSA1,1155,13 146.19 (2m) Grants to tribal health centers. Subject to 1999 Wisconsin Act .... (this act), section 9123 (6tu), from the appropriation under s. 20.435 (5) (ke), the department shall award grants for the provision or purchase of health care services for tribal members and their families to tribal health care entities that provide primary health care, health education and social services to tribal members and their families and to tribal employes. The department shall establish by rule criteria for distributing grants to the health care entities. In developing the criteria, the department shall consider each tribe's financial need, resources available to each tribe and other demographic health status indicators.

SB45-SSA1, s. 2251 Section 2251. 146.56 (1) of the statutes is amended to read:

SB45-SSA1,1155,18 146.56 (1) Not later than July 1, 2001 2002, the department shall develop and implement a statewide trauma care system. The department shall seek the advice of the statewide trauma advisory council under s. 15.197 (25) in developing and implementing the system.

SB45-SSA1, s. 2251d Section 2251d. 146.57 (title) of the statutes is amended to read:

SB45-SSA1,1155,20 146.57 (title) Statewide poison control program system.

SB45-SSA1, s. 2251e Section 2251e. 146.57 (1m) of the statutes is created to read:

SB45-SSA1,1155,22 146.57 (1m) Definitions. In this section:

SB45-SSA1,1155,23 (a) "Appropriate health-oriented background" means one of the following:

SB45-SSA1,1156,3 1. Licensure as an emergency medical technician — basic, emergency medical technician — intermediate or emergency medical technician — paramedic under s. 146.50 (5) (a).

SB45-SSA1,1156,4 2. Licensure as a licensed practical nurse under s. 441.10 (3).

SB45-SSA1,1156,10 3. Completion of a training program directed by a physician specializing in toxicology and, as determined by the medical director of a poison control center, background sufficient to understand and interpret standard poison information resources and to transmit that information understandably to both health professionals and the public under the direct supervision of a staff member specified under sub. (3m) (b) or the medical director.

SB45-SSA1,1156,13 (b) "On-line staff member" means a member of the staff of a poison control center who personally responds to telephone inquiries received by the poison control center.

SB45-SSA1,1156,14 (c) "Pharmacist" has the meaning given in s. 450.01 (15).

SB45-SSA1,1156,15 (d) "Physician" has the meaning given in s. 448.01 (5).

SB45-SSA1,1156,17 (e) "Poison control services" means poison prevention education, and rapid and accurate poison interpretation, poison intervention and management information.

SB45-SSA1,1156,18 (f) "Registered nurse" means a nurse who is licensed under s. 441.06.

SB45-SSA1,1156,20 (g) "School of pharmacy" means a school of pharmacy that is accredited by the American Council on Pharmaceutical Education.

SB45-SSA1,1156,22 (h) "Triage" means assign priority order on the basis of where resources can best be used or are most needed.

SB45-SSA1, s. 2251f Section 2251f. 146.57 (3) (a) of the statutes is amended to read:

SB45-SSA1,1157,8 146.57 (3) (a) The department shall implement a statewide poison control program system, which shall provide poison control services that are available statewide, on a 24-hour per day and 365-day per year basis and shall provide poison information and education to health care professionals and the public. From the appropriation under s. 20.435 (5) (ds), the department shall, if the requirement under par. (b) is met, distribute total funding of not more than $375,000 in each fiscal year to supplement the operation of the program system and to provide for the statewide collection and reporting of poison control data. The department may, but need not, distribute all of the funds in each fiscal year to a single poison control center.

SB45-SSA1, s. 2251g Section 2251g. 146.57 (3m) of the statutes is created to read:

SB45-SSA1,1157,13 146.57 (3m) Requirements of poison control centers. (a) A poison control center shall maintain telephone services capable of providing rapid, accurate and complete poison information that is accessible throughout the state and that is free to users through a statewide toll-free hotline.

SB45-SSA1,1157,15 (b) An on-line staff member who interprets poison exposure data and provides poison intervention and management information shall be one of the following:

SB45-SSA1,1157,16 1. A registered nurse.

SB45-SSA1,1157,17 2. A pharmacist.

SB45-SSA1,1157,18 3. A physician.

SB45-SSA1,1157,20 4. A person who is certified by or eligible for certification by the American Association of Poison Control Centers as a specialist in poison information.

SB45-SSA1,1157,21 5. A school of pharmacy graduate who is in residency training.

SB45-SSA1,1157,23 6. A school of pharmacy enrollee who has completed the 2nd professional practice year.

SB45-SSA1,1158,3 7. A person who was employed as an on-line staff member on May 1, 1994, who has worked in that capacity at the poison control center for at least 3 years and who annually receives at least 16 documented hours of continuing education in interpreting poison exposure data and providing poison intervention and management information.

SB45-SSA1,1158,7 (c) An on-line staff member who is designated as a poison information provider may, if he or she annually receives at least 16 documented hours of job-relevant continuing education and has an appropriate health-oriented background, provide poison information to manage nontoxic exposures and routine follow-up.

SB45-SSA1,1158,11 (d) An on-line staff member who is designated as a poison information provider shall triage incoming telephone calls concerning toxic exposures and, for health care professionals, concerning drug interaction interpretations, and refer such calls to an on-duty staff member under par. (b).

SB45-SSA1, s. 2254 Section 2254. 146.93 (1) (a) of the statutes is amended to read:

SB45-SSA1,1158,16 146.93 (1) (a) From the appropriation under s. 20.435 (1) (4) (gp), the department shall maintain a program for the provision of primary health care services based on the primary health care program in existence on June 30, 1987. The department may promulgate rules necessary to implement the program.

SB45-SSA1, s. 2255 Section 2255. 146.99 of the statutes is amended to read:

SB45-SSA1,1158,25 146.99 Assessments. The department shall, within 90 days after the commencement of each fiscal year, estimate the total amount of expenditures and the department shall assess the estimated total amount under s. 20.435 (1) (4) (gp) to hospitals, as defined in s. 50.33 (2), in proportion to each hospital's respective gross private-pay patient revenues during the hospital's most recently concluded entire fiscal year. Each hospital shall pay its assessment on or before December 1 for the fiscal year. All payments of assessments shall be deposited in the appropriation under s. 20.435 (1) (4) (gp).

SB45-SSA1, s. 2255m Section 2255m. 149.10 (3e) of the statutes is created to read:

SB45-SSA1,1159,2 149.10 (3e) "Fund" means the health insurance risk-sharing plan fund.

SB45-SSA1, s. 2256 Section 2256. 149.12 (2) (d) of the statutes is renumbered 149.12 (2) (d) 1. and amended to read:

SB45-SSA1,1159,7 149.12 (2) (d) 1. Except for a person who is an eligible individual as provided in subd. 2., no person who is 65 years of age or older is eligible for coverage under the plan.

SB45-SSA1, s. 2257 Section 2257. 149.12 (2) (d) 2. of the statutes is created to read:

SB45-SSA1,1159,9 149.12 (2) (d) 2. Subdivision 1. does not apply to any of the following:

SB45-SSA1,1159,10 a. A person who is an eligible individual.

SB45-SSA1,1159,12 b. A person who has coverage under the plan on the date on which he or she attains the age of 65 years.

SB45-SSA1, s. 2258 Section 2258. 149.12 (3) (b) of the statutes is amended to read:

SB45-SSA1,1159,19 149.12 (3) (b) Persons for whom deductible or coinsurance amounts are paid or reimbursed under ch. 47 for vocational rehabilitation, under s. 49.68 for renal disease, under s. 49.685 (8) for hemophilia, under s. 49.683 for cystic fibrosis or, under s. 253.05 for maternal and child health services or under s. 49.686 for the cost of drugs for the treatment of HIV infection or AIDS are not ineligible for coverage under the plan by reason of such payments or reimbursements.

SB45-SSA1, s. 2258d Section 2258d. 149.125 of the statutes is repealed.

SB45-SSA1, s. 2258f Section 2258f. 149.14 (2) (a) of the statutes is amended to read:

SB45-SSA1,1160,3 149.14 (2) (a) The plan shall provide every eligible person who is not eligible for medicare with major medical expense coverage. Major medical expense coverage offered under the plan under this section shall pay an eligible person's covered expenses, subject to sub. (3) and deductible, copayment and coinsurance payments authorized under sub. (5), up to a lifetime limit of $1,000,000 per covered individual. The maximum limit under this paragraph shall not be altered by the board, and no actuarially equivalent benefit may be substituted by the board.

SB45-SSA1, s. 2259 Section 2259. 149.14 (3) (intro.) of the statutes is amended to read:

SB45-SSA1,1160,19 149.14 (3) Covered expenses. (intro.) Except as provided in sub. (4), except as restricted by cost containment provisions under s. 149.17 (4) and except as reduced by the board under s. 149.15 (3) (e) or by the department under s. ss. 149.143 or and 149.144, covered expenses for the coverage under this section shall be the usual and customary charges payment rates established by the department under s. 149.142 for the services provided by persons licensed under ch. 446 and certified under s. 49.45 (2) (a) 11. Except as provided in sub. (4), except as restricted by cost containment provisions under s. 149.17 (4) and except as reduced by the board under s. 149.15 (3) (e) or by the department under s. ss. 149.143 or and 149.144, covered expenses for the coverage under this section shall also be the usual and customary charges payment rates established by the department under s. 149.142 for the following services and articles if the service or article is prescribed by a physician who is licensed under ch. 448 or in another state and who is certified under s. 49.45 (2) (a) 11. and if the service or article is provided by a provider certified under s. 49.45 (2) (a) 11.:

SB45-SSA1, s. 2259f Section 2259f. 149.14 (3) (d) of the statutes is amended to read:

SB45-SSA1,1160,21 149.14 (3) (d) Drugs requiring a physician's prescription, subject to sub. (4c).

SB45-SSA1, s. 2259r Section 2259r. 149.14 (4) (d) of the statutes is amended to read:

SB45-SSA1,1161,2 149.14 (4) (d) That part of any charge for services or articles rendered or prescribed by a physician, dentist or other health care personnel which that exceeds the prevailing charge in the locality where the service is provided payment rate established by the department under s. 149.142 and reduced under ss. 149.143 and 149.144 or any charge not medically necessary.

SB45-SSA1, s. 2260 Section 2260. 149.14 (4) (g) of the statutes is amended to read:

SB45-SSA1,1161,4 149.14 (4) (g) Dental care except as provided in sub. (3) (m) and (q).

SB45-SSA1, s. 2260c Section 2260c. 149.14 (4) (n) of the statutes is created to read:

SB45-SSA1,1161,7 149.14 (4) (n) Services or drugs for the treatment of infertility, impotence or sterility.

SB45-SSA1, s. 2260d Section 2260d. 149.14 (4c) of the statutes is created to read:

SB45-SSA1,1161,11 149.14 (4c) Coverage of prescription drugs. (a) The department may require a pharmacist or pharmacy that provides a prescription drug to an eligible person to submit a payment claim directly to the plan administrator.

SB45-SSA1,1161,14 (b) The department may limit coverage of prescription drugs under sub. (3) (d) to those prescription drugs for which payment claims are submitted by pharmacists or pharmacies directly to the plan administrator.

SB45-SSA1, s. 2260h Section 2260h. 149.14 (4m) of the statutes is amended to read:

SB45-SSA1,1161,22 149.14 (4m) Payment is payment in full. Except for copayments, coinsurance or deductibles required or authorized under the plan, a provider of a covered service or article shall accept as payment in full for the covered service or article the payment rate determined under ss. 149.142, 149.143, and 149.144 and 149.15 (3) (e) and may not bill an eligible person who receives the service or article for any amount by which the charge for the service or article is reduced under s. 149.142, 149.143, or 149.144 or 149.15 (3) (e).

SB45-SSA1, s. 2260m Section 2260m. 149.14 (5) (title) of the statutes is amended to read:

SB45-SSA1,1161,24 149.14 (5) (title) Deductibles, copayments and coinsurance.

SB45-SSA1, s. 2260p Section 2260p. 149.14 (5) (e) of the statutes is created to read:

SB45-SSA1,1162,5 149.14 (5) (e) Subject to sub. (8) (b), the department may, by rule under s. 149.17 (4), establish copayments for prescription drug coverage under sub. (3) (d). Any copayment amounts or rates established are subject to the approval of the board. Copayments paid by an eligible person under this paragraph shall count toward the deductible and covered costs not paid by the plan under pars. (a) to (c).

SB45-SSA1, s. 2261 Section 2261. 149.14 (6) (title) of the statutes is created to read:

SB45-SSA1,1162,7 149.14 (6) (title) Preexisting conditions.

SB45-SSA1, s. 2261f Section 2261f. 149.14 (8) of the statutes is created to read:

SB45-SSA1,1162,12 149.14 (8) Applicability of medical assistance provisions. (a) Except as provided in par. (b), the department may, by rule under s. 149.17 (4), apply to the plan the same utilization and cost control procedures that apply under rules promulgated by the department to medical assistance under subch. IV of ch. 49.

SB45-SSA1,1162,15 (b) The department may not apply to eligible persons for covered services or articles the same copayments that apply to recipients of medical assistance under subch. IV of ch. 49 for services or articles covered under that program.